Course contents
Why Breastfeeding is Important
Biochemistry
- 1 a. Protein
- 2 b. Carbohydrates
- 3 c. Milk Lipids (fats)
- 4 d. Vitamins
- 5 e. Minerals
- 6 f. Water
- 7 The taste of breastmilk
- 7.1 Dietary advice
- 8 What should I remember?
- 9 Self-test Quiz
Immunology
- 1 Protective components of breastmilk
- 1.1 Proteins
- 1.1.1 Immunoglobulins
- 1.1.2 Lactoferrin
- 1.1.3 Alpha-Lactalbumin
- 1.1.4 Lysozyme
- 1.2 Carbohydrates
- 1.2.1 Oligosaccharides
- 1.3 Lipids and milk fat globules
- 1.4 Cellular components
- 1.5 Other protective factors
- 1.1 Proteins
- 2 What should I remember?
- 3 Self-test Quiz
Relative risks
- 1 Acute diseases attributable to artificial feeding
- 2 Chronic diseases attributable to artificial feeding
- 3 Developmental Deficits
- 3.1 Intelligence
- 4 Sudden Infant Death Syndrome (SIDS)
- 5 What should I remember?
- 6 Self-test Quiz
- 7 Assessment Quiz
Communication Skills
- 1 Personal Qualities
- 1.1 Genuineness
- 1.2 Non-possessive love
- 1.3 Empathy
- 2 What should I remember?
- 3 Self-test quiz
Non-verbal
- 1 What do you want to communicate?
- 1.1 Posture
- 1.2 Appropriate body motion
- 1.3 Eye contact
- 1.4 Minimal encouragers
- 1.5 Non-distracting environment
- 1.6 Time
- 2 What should I remember?
- 3 Self-test Quiz
Listening skills
- 1 Reflective listening
- 1.1 Paraphrasing
- 1.2 Reflecting feelings
- 2 Appropriate questioning
- 3 What should I remember?
Building confidence
- 1 Acceptance
- 2 Avoiding judgmental words
- 3 Acknowledge what is right
- 4 Use language that is easily understood
- 5 Provide relevant information
- 6 What should I remember?
An example
Pregnancy Care
- 1 Baby Friendly Step 3 and Point 3
- 2 Broaching the topic
- 3 When the mother does not breastfeed
- 4 What should I remember?
The feeding decision
- 1 What is most influential?
- 2 But not everyone can breastfeed!
- 3 What should I remember?
- 4 Self -test quiz
The barriers
- 1 Societal barriers
- 2 Health provider knowledge, skills and management
- 3 Postnatal perceptions
- 4 Breastfeeding in special circumstances
- 5 What should I remember?
Physical preparation
- 1 Nipple preparation
- 2 Prenatal breast examination
- 2.1 Inspection
- 2.2 Palpation
- 3 Record-keeping
- 4 What should I remember?
- 5 Self-test Quiz
- 5.1 Assessment Quiz
The Birth Experience
The first hours
- 1 Baby Friendly Step 4
- 2 Immediately following birth
- 3 The first breastfeed
- 4 The role of the birth attendants
- 5 Addressing barriers to skin-to-skin
- 6 Maternal-infant bonding
- 7 What should I remember?
- 8 Self-test quiz
Labor interventions
- 1 Analgesia during labor
- 2 Neuraxial pain relief (epidural/spinal)
- 3 Cesarean (caesarean) section or vaginal instrumental birth
- 4 Assisting a mother following an assisted delivery
- 5 What should I remember?
- 6 Self-test quiz
Postnatal interventions
- 1 Separation of mother and newborn
- 2 Washing mother or newborn
- 3 Suctioning of the newborn
- 4 What should I remember?
- 5 Self-test quiz
- 6 Assessment Quiz
Breastfeeding the Baby
Positioning Principles
- 1 Mother's position
- 2 Baby's position
- 3 The well-latched baby
- 4 What should I remember?
- 5 Self-test Quiz
Breastmilk transfer
- 1 Understanding the anatomy
- 2 Positive pressure transfer
- 3 Negative pressure transfer
- 4 What should I remember?
- 5 Self-test Quiz
Assessing breastfeeding
A time to learn
- 1 How to provide education effectively
- 2 Postnatal education
- 3 What should I remember?
- 4 Self-test quiz
Practical skills
- 1 Baby Friendly Step 5 and Point 4
- 2 Expressing breastmilk
- 3 Supporting mothers who are separated from their infants
- 4 What should I remember?
- 5 Self-test quiz
Breastfeeding messages
- 1 Baby Friendly Step 8
- 2 How often should my baby breastfeed?
- 3 Is my baby getting enough breastmilk?
- 4 When should I begin giving baby other foods?
- 5 When should I wean my baby from the breast?
- 6 What should I remember?
- 7 Self-test quiz
Normal growth
- 1 Weighing of babies is not an innocuous procedure
- 2 What influences movement through growth curves?
- 3 Accurately weighing an infant
- 4 What should I remember?
- 5 Self-test Quiz
Sleep
- 1 Rooming-in in Hospital
- 2 How long should my baby sleep?
- 3 Where should my baby sleep?
- 4 What should I remember?
- 5 Self-test Quiz
Psychological support
- 1 Maternal self-confidence and self-efficacy
- 2 Influencing self-confidence and self-efficacy
- 3 What should I remember?
- 4 Self-test Quiz
Discharge planning
- 1 Preventing common problems
- 2 Consolidating learning
- 3 What should I remember?
- 4 Self-test Quiz
- 5 Assessment Quiz
Infant Challenges
Late preterm infant; Non-latching
Hypoglycemia; Jaundice
Supplementation
- 1 Exclusive breastfeeding
- 2 Pre-lacteal feeds
- 3 Supplementation
- 3.1 Medical indications for supplementation
- 3.2 Effect on infant health
- 3.3 Effect on breastfeeding
- 3.4 Effect on the mother
- 3.5 Effect on infant serum glucose levels
- 3.6 Effect on hyperbilirubinemia
- 3.7 Effect on atopic disease
- 3.8 Effect on infant digestion and absorption
- 3.9 Human Immunodeficiency Virus (HIV)
- 3.10 Legal implications
- 3.11 What should I remember?
- 3.12 Self-test quiz
Crying baby
- 1 My baby cries a lot. What should I do?
- 2 Pacifiers/Dummies
- 3 When crying is excessive
- 3.1 Lactose malabsorption/overload
- 3.1.1 Presentation
- 3.1.2 Management
- 3.2 Colic
- 3.2.1 Management
- 3.3 Gastroesophageal Reflux
- 3.1 Lactose malabsorption/overload
- 4 What should I remember?
- 5 Self test quiz
Inadequate weight gain
- 1 Definition of failure to thrive (FTT)
- 2 Cause of failure to thrive
- 3 What to do when you suspect FTT
- 3.1 Record a thorough history
- 3.2 Examination of the baby
- 3.2.1 Test weighing
- 3.2.2 What do you see?
- 4 Management
- 4.1 Parent education and counseling
- 4.2 Step 1
- 4.3 Step 2
- 4.4 Step 3
- 4.5 Step 4
- 5 What should I remember?
- 6 Self-test quiz
- 7 Assessment Quiz
Feeding-line device at the breast
Cup feeding
Finger Feeding
Bottle feeding
- 1 When to use bottle feeding
- 2 Considerations when bottlefeeding a breastfed infant
- 3 Bottle feeding technique
- 4 Good bottle feeding practices are essential
Maternal Challenges
Engorgement
- 1 Breast fullness
- 2 Engorgement
- 3 Clinical Management
- 4 Areolar oedema/edema
- 5 What should I remember?
- 6 Self-test quiz
Nipple Pain
- 1 Technique factors
- 2 Maternal anatomy issues
- 3 Infant anatomy issues
- 3.1 Ankyloglossia (tongue tie)
- 3.1.1 Presentation
- 3.1.2 Treatment
- 3.1 Ankyloglossia (tongue tie)
- 4 Nipple infections
- 5 Treatment of nipple damage
- 6 What should I remember?
- 7 Self-test quiz
Breast Problems
- 1 Blocked (Plugged) Duct
- 2 Mastitis
- 2.1 Aetiology
- 2.2 Preventing Mastitis
- 2.3 Diagnosis
- 2.4 Management
- 2.5 Complications
- 3 What should I remember?
- 4 Self-test quiz
Insufficient breastmilk
- 1 Perceived breastmilk insufficiency
- 2 How is breastmilk production regulated?
- 3 Insufficient breastmilk
- 3.1 Diagnosis
- 3.1.1 Delayed onset
- 3.2 Management
- 3.1 Diagnosis
- 4 What should I remember?
- 5 Self-test quiz
Medical, Surgical Issues
- 1 Diabetes mellitus
- 2 Maternal overweight and obesity
- 3 Thyroid disease
- 4 Hepatitis
- 5 HIV
- 6 Breast surgery
- 7 Breastfeeding and medication usage
- 8 What should I remember?
- 9 Self-test quiz
- 10 Assessment Quiz
Promotion, Protection and Support
The International Code of Marketing of Breastmilk Substitutes
- 1 Aim of the WHO Code
- 2 What's covered by the WHO Code?
- 3 Promotion and product information
- 4 Free samples
- 5 What can you do?
- 6 What should I remember?
- 7 Self-test quiz
The Baby Friendly Initiative
Young Child Feeding
Local initiatives
- 1 Breastfeeding in public
- 2 Supporting mothers in the community
- 3 Engaging the Community
- 4 What should I remember?
- 5 Self-test quiz
- 6 Assessment Quiz
Infant feeding in emergencies
- 1 The problem
- 2 The solution for the breastfed infant
- 3 The solution for the artificially fed infant
- 4 What can you do to help?